Gop, Democrats Part Ways On Medicare Hearings

WASHINGTON — On a rainy Friday long on symbolism and short on substance, House Democrats and Republicans held competing events as the political debate over Medicare's future erupted on Capitol Hill.

Each side, playing to the ever- present television cameras, attempted to score points and influence congressional votes that may come as early as next week.

Democrats got started first, holding a rain-spattered mock hearing on the soaked lawn of the U.S. Capitol to blast the Republican plan for cutting projected Medicare spending by $270 billion over the next seven years. They said they were especially angry that Republicans were holding only one hearing on the proposal.

``Speaker [Newt] Gingrich [R- Ga.] and [Sen.] Bob Dole [R-Kan.] have decided that when it comes to the future of Medicare . . . the details should be hidden, the debate smothered and democracy should be denied,'' House Minority Leader Richard A. Gephardt, D-Mo., told an audience huddled under umbrellas.

Inside the ornate and drier confines of the House Ways and Means Committee room, site of a titanic battle last year over President Clinton's health care reform proposal, Republicans had their say a short while later.

Presiding over the day's official hearing, a marathon session that lasted more than six hours, committee Chairman Bill Archer, R-Texas, recited again the April warning from the Medicare trustees that the federal health program for 37 million elderly Americans would be broke in seven years.

Accusing Democrats of ignoring the problem for years, Archer said, ``Our plan is bold, it is innovative and, most importantly, it protects Medicare for today's retirees and it preserves it for the next generation of seniors.''

The first witness called by the Republicans, who put the agenda together, appeared to undermine their case, however.

Roland E. King, former chief actuary for the agency that runs Medicare, estimated it would take only $160 billion to make the Medicare hospital fund solvent for the immediate future, not the $270 billion that Republicans have proposed squeezing out of the program.

Asked by Rep. Barbara B. Kennelly, D-1st District, if it was necessary to take the remaining $110 billion from a separate fund that pays doctor bills, King replied, ``I really haven't looked at that.'' But he did say that savings from one fund could not be used to bolster the other.

The fund that pays doctor bills has no immediate solvency problems.

Several Democrats also got King to say that he had seen neither the full Republican plan nor the 60- page summary they released Thursday. While King said he believed the Republican proposal would make Medicare secure at least until 2111, he said his estimate was based on newspaper reports rather than firsthand knowledge.

The hearing also provided the first opportunity for more than a dozen groups to comment on the Republican plan, which the Ways and Means Committee is expected to complete action on by Friday.

One of the most enthusiastic reactions came from the American Medical Association. P. John Seward, chairman of its board, told the committee, ``Many of the elements of the outline appear to be in concert with physicians' concerns regarding the preservation of patient choice and the sustaining of quality medical care.''

The proposal would allow doctors and hospitals to form new health care networks that would compete with private insurers.

Insurers who testified generally liked the plan. But they said they were not happy that new networks proposed in the plan would not have to comply with the same solvency and antitrust rules as insurance company-sponsored plans.

``While we welcome competition, we do not welcome competition in an unlevel regulatory environment,'' said John F. Troy, executive vice president of the Health Insurance Association of America, a trade group.

Different rules could give the networks a competitive advantage, Troy said.

One of the strongest complaints about the Republican plan came from the American Hospital Association. Gail Warden, its chairwoman, told the committee that reductions in projected spending contemplated by Republicans ``could translate into real cuts'' if payments to hospitals do not keep up with inflation.

Warden said that, as she understood the plan, hospitals would not receive annual increases large enough to match inflation and that, as a result, they would face ``an extremely difficult, if not impossible, task.''

The hearing was interrupted by a brief protest by 18 people who said they were members of the National Council of Senior Citizens. ``We have no voice'' and ``Newt Gingrich should be arrested'' they shouted before police officers escorted them from the committee room.

The protesters then walked into the rain to participate in the outdoor hearing. Democrats stayed outside to make the point that they were excluded from drafting the Republican proposal, which is not yet in its final form.

Bob Hug, a retired tax accountant from Milford, Conn., who is on Medicare, waited more than two hours in the rain and mud before testifying at the outdoor hearing.

Hug went through an elaborate description of his personal finances, concluding, ``If the Republican Medicare plan passes and we are forced to pay twice as much for Medicare premiums, I don't know how we are going to afford it.''

Also appearing at the outdoor event was Labor Secretary Robert Reich, a Medicare trustee, who said that ``$270 billion worth of cuts are not necessary to keep the [hospital] trust fund solvent.'' Democrats complain that more than $100 billion of the savings is earmaked for a proposed Republican tax cut.

In a related development, Senate Finance Committee Republicans released the outline Friday of their plan to reduce projected Medicare spending, also by $270 billion. With a few exceptions, it mirrors the House Republican plan.